James Browne (Wexford, Fianna Fail)
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My question is more for Professor Kennedy. In 1950, there were 7.9 beds per 1,000 of the population and 22,000 citizens were hospitalised in psychiatric hospitals. According to the Health Research Board, HRB, there were 17,290 admissions in our hospital psychiatric units in 2016. That is a rate of 376 admissions per 100,000. The HRB went on to state that the rate of involuntary admission in 2016 was 48.4 per 100,000. It is 120 in the UK. That is almost double the rate of involuntary admissions. In the EU 28, Ireland has the third lowest number of psychiatric beds per 100,000 according to EUROSTAT. That is a dramatic change over the last 60 years. The EU average seems to be 72 psychiatric beds per 100,000 and, according to EUROSTAT, in Ireland it 35 per 100,000. That is again less than half of the EU average.

Professor Brendan Kelly has been reported saying, "These are stark differences and strongly suggest that Ireland has insufficient psychiatric beds to serve our population." He went on to say that the "movement away from the excessive inpatient care [in the] 1950s ... towards the present situation [when the] rate of involuntary admission is less than half of that in England, and [that] Ireland’s availability of psychiatric beds is less than half of the EU average." He continued that "the key human rights issue in Irish psychiatry today is not [the] disproportionate denial of the right to liberty due to over-custodial care, but, rather, issues concerning the right to access to an appropriate level of care when it is needed, including inpatient care". That would seem to chime with what Professor Kennedy said earlier. Does he think that decongregation - that is the buzzword used - has gone too far? Has it become either an ideology, or worse, a badge of convenience to effectively shut many units that perhaps, it would have been better to have replaced or done up? I have heard this reflected elsewhere.

Have we gone too far such that policy is no longer based on the clinical need of the individual but on getting as many people as possible out into the community, irrespective of clinical need and what community supports are in place for them?